Clinical and Organizational Factors Related to the Reduction of Mechanical Restraint Application in an Acute Ward: An 8-Year Retrospective Analysis

Background: The purpose of this study was to describe the frequency of mechanical restraint use in an acute psychiatric ward and to analyze which variables may have significantly influenced the use of this procedure. Methods: This retrospective study was conducted in the Servizio Psichiatrico di Diagnosi e Cura (SPDC) of Modena Centro. The following variables of our sample, represented by all restrained patients admitted from 1-1-2005 to 31-12-2012, were analyzed: age, gender, nationality, psychiatric diagnoses, organic comorbidity, state and duration of admission, motivation and duration of restraints, nursing shift and hospitalization day of restraint, number of patients admitted at the time of restraint and institutional changes during the observation period. The above variables were statistically compared with those of all other non-restrained patients admitted to our ward in the same period. Results: Mechanical restraints were primarily used as a safety procedure to manage aggressive behavior of male patients, during the first days of hospitalization and night shifts. Neurocognitive disorders, organic comorbidity, compulsory state and long duration of admission were statistically significantly related to the increase of restraint use (p<.001, multivariate logistic regression). Institutional changes, especially more restricted guidelines concerning restraint application, were statistically significantly related to restraint use reduction (p<.001, chi2 test, multivariate logistic regression). Conclusion: The data obtained highlight that mechanical restraint use was influenced not only by clinical factors, but mainly by staff and policy factors, which have permitted a gradual but significant reduction in the use of this procedure through a multidimensional approach

SOME RESULTS OF THE U CrB OBSERVATIONS IN 1856 - 2007

Historical results over of photometry of eclipsing variable star U CrB (type of EA / SD) are brought after 1856 - 2007. Authors suppose that in the system U CrB there is a trade-out by a substance between components

Factors influencing workplace violence risk among correctional health workers: insights from an Australian survey

Little is known about the environmental and organisational determinants of workplace violence in correctional health settings. This paper describes the views of health professionals working in these settings on the factors influencing workplace violence risk. All employees of a large correctional health service in New South Wales, Australia, were invited to complete an online survey. The survey included an open-ended question seeking the views of participants about the factors influencing workplace violence in correctional health settings. Responses to this question were analysed using qualitative thematic analysis. Participants identified several factors that they felt reduced the risk of violence in their workplace, including: appropriate workplace health and safety policies and procedures; professionalism among health staff; the presence of prison guards and the quality of security provided; and physical barriers within clinics. Conversely, participants perceived workplace violence risk to be increased by: low health staff-to-patient and correctional officer-to-patient ratios; high workloads; insufficient or underperforming security staff; and poor management of violence, especially horizontal violence. The views of these participants should inform efforts to prevent workplace violence among correctional health professionals

Institutional infractions among young prisoners: a longitudinal study

Using a longitudinal design, this study describes changes in institutional infractions among a sample of 75 young males in a Portuguese prison. The inmates were assessed at 1, 3, 6, and 12 months after entry. The total number of infractions peaked at the third month and then declined. Although the pattern of severe infractions was irregular, minor infractions increased until the sixth month and decreased thereafter. Major predictors of inmates' infractions during the first year in the institution were fewer visits, being single and non-White, having higher hostility levels, younger age at first imprisonment, and being a property offender.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research is part of an individual PhD supported by the Portuguese Foundation for Science and Technology with co-financing of the European Social Fund, grant number SFRH/BD/66987/2009.info:eu-repo/semantics/publishedVersio